Mentor End-of-Year Questionnaire, Spring 2016
Please take a moment to give us some feedback on your mentoring experience this past
year and on your availability for the upcoming year. Thank you for your time!
Availability:
Are you interested in continuing to mentor for the next academic year (Fall 2016 to Spring
2017)?
Yes_____ No_____
If no, please tell us why.
__________________________________________________________
Please indicate any changes over the past year in your name, address, phone number,
e-mail addresses, continuing education, employer, or job title.
_______________________________________________________________________
_______________________________________________________________________
________________
If your current mentee indicates interest in continuing with the program (and if he or she
is not graduating this semester or in the fall of 2016), which would you prefer:
a. To continue working with your current mentee if they express the same preference
Yes____ No____
b. Starting next Fall with a different mentee
Yes____ No____
c. I have no preference—open to either
Yes____ No____
Meetings and Activities with Mentee:
How often did you meet with your mentee in person? ____________
By phone? ________
By email? ________
In what locations did the in-person meetings take place?
_______________________________________________________________________
_______________________________________________________________________
________________
What activities did you and your mentee participate in?
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
________________________
What suggestions did you make for activities for your mentee to consider and did he or
she, to your knowledge, follow through with these suggestions?
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
_______________________
Mentor-Mentee Relationship:
Overall, how would you describe the quality of your mentor-mentee relationship?
Low _____ Moderate _____ High _____
Comments:______________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
_______________________
How satisfied were you with the interpersonal communication and your ability to relate
well with one another as mentor and mentee?
Not Very Satisfied______ Moderately Satisfied_____ Highly Satisfied_____
Comments:______________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
_______________________
Were there areas of interpersonal communication where you encountered challenges?
Several Challenges_____ A Few Challenges _____ No Challenges _____
If yes, what were they?
_______________________________________________________________________
_______________________________________________________________________
________________
Mentee’s Preparation for the Job Market:
What is your assessment of your mentee’s level of preparation in the soft skills
(interpersonal communication, speaking & writing, decision-making, etc.) needed for the
job market?
Low Preparation_____ Moderate Preparation_____ High Preparation_____
Comments:______________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
_______________________
Program Moodle Container:
How often did you use the Mentoring Program Moodle Container?
Never____A few times_____Once a month____ Once a week or more____
How useful did you find the program Moodle Container?
Not very useful_____ Moderately useful_____ Highly useful_____
What was most helpful and informative about the program Moodle Container?
_______________________________________________________________________
___
Do you have any ideas for additional information or functions you would like to see on the
program Moodle Container?
_______________________________________________________________________
_______________________________________________________________________
________________
Additional Comments:
Please share with us any other comments about your experiences with and
recommendations for the program:
_______________________________________________________________________
_______________________________________________________________________
________________
_______________________________________________________________________
________
_______________________________________________________________________
_______________________________________________________________________
________________
Recommendations for Future Mentors:
We will soon begin recruiting mentors and mentees for Fall 2016. Do you know someone
who would be interested in being a mentor in this program next year? Yes____ No____
If yes, then please consider asking this person if he or she would like to be a mentor.
Please share with us the person’s name and contact information (if they would like us to
contact them).
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
______________________
Thank you!!
Katherine Brown